Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
A man having question

Food for Thought

One of my “day jobs” is working “background” on various films and TV shows filming in New York. To give an example of a typical today on a set, I’d like to use the phrase “hurry up and wait”. Sometimes we have to get there by a certain time, which is usually very early in the morning on very little sleep. We check in, then we have to get dressed, have make-up and hair done, have photos taken of us on phones which will be sent to various departments for “approval”, and then we literally just sit around and wait.

Sometimes, when I’m working with my car, it means that I’m going to either be sitting in my car for long periods of time by myself, or possibly sitting around inside a basement, church, etc.

During this time where asked to stay in something called “holding” as described above, where there’s very little to do if you did not bring something to read, or there is no WiFi to work on your computer. We do end up talking, or checking messages on our phones, but mostly, we are confined to our small space except for being allowed to go to something called “crafty”, as we may be called at any moment to work on set.

“Crafty” is basically a table under a tent filled with plenty of food. Some are healthy, and some are not. You’ll see lots of coffee pods in various flavors that work in a Keurig or similar machine. There will be lots of candy, cookies, and other sweet treats that will satisfy a sweet tooth, and then lead to a sugar crash.  But if you look carefully, there are many healthy options to choose from under the tent.

Typically, many people will go for the carbs, and simple sugars, but if you are conscious, one will also see that there many delicious foods that are easy to grab such as, cut bell peppers, fresh mango slices, celery, carrot sticks, pita bread, hummus for dipping, small sandwiches, oranges and bananas… One can make peanut butter or almond butter sandwiches, and although I like my coffee, having more than one would not be a good idea, so I switch to herbal tea and water for the rest of the day.

The trick to eating on set, vacation, or even a party, is training yourself to decide what is healthy and what is not. Training yourself to decide what is satisfying in the long run that will give you true energy, as well as nutritionally. If you need such a sweet fix, having a piece of watermelon or cut mango is way more satisfying then say, a cookie or a big piece of cake — that doesn’t give long-lasting energy, has less nutritional value, and doesn’t fill you up the same way as fruit. And adding a small protein will also satiate you longer than simple sugars.

I derive enjoyment from mangoes, watermelon, veggies that are cut for me, vs. candy and cookies, knowing this type of sweetness is more satisfying, nourishing, and will fuel my workouts when I finish, even when I am sitting around in holding in the rain.

Also, there is a beauty in eating from a color palette. Having red, such as red peppers and watermelon; orange — baby carrots; yellow — pre-cut peppers and mangoes; green — celery, spinach, lettuce, honeydew; blue — blueberries; purple — beet juice (which is made for us in a juice press or machine). It’s so much more satisfying than having your typical beige and brown food (unless you include hummus and almond butter!).

On the second day of last week’s project, I knew that basically they were just using my car and not me. So I took the liberty of walking up and down the block many times, which had a nice incline, but staying close to set in case I was suddenly called.

Granted, I did do my yoga workout that morning, and lifted my weights similar to the weight workouts found in Healthy Things You Can Do In Front of the TV for Chest, Rows, Biceps, Triceps, and a few abdominals, as well as Rear Flies and Chest Flies. But I did want to supplement my workout with a little bit of cardio, so I had been walking up and down the hill attempting to get a little bit of my cardio in that day while the sun was out, and the air was fresh.

It also inspired me to write this article.

Although there is “crafty”, there will also be a fully catered lunch. Like “crafty”, there are also many healthy and unhealthy to choose from. Many folks will go for the meat, and many will go for the sweet cakes at the dessert table, as they do look pretty.  However, if you look at my plate, you will see: brown rice, spinach, swordfish, and grilled vegetables. I opted out of dessert, because I know that there will be “crafty” later on, where the be plenty of cut fruit and other treats for me to partake from.

Speaking with the crew on set that day, as well as other actors in holding, many of them want to work out, and don’t have the time. Hence why the exercises in Healthy Things You Can Do In Front of the TV are so important. Even just choosing a few of them while you’re on a break or in holding can be done while you’re sitting down, such as the leg lifts while you’re in a chair, or standing leg lifts holding the chair back, simple or 1 legged squats, or even lunges. These are all things you can do when you’re cramped up in a small space or in between takes. The crew, who need to lift a heavy equipment could do things like “roll downs”,  Warrior 1 and 2, forward bending stretches with one leg forward, using the equipment as a props to help them stretch the tight hamstrings. It is very important to keep your hamstrings in check so that your lower back does not give way when lifting heavy equipment, or wearing a camera on a shoulder harness.

In closing, when presented with many options, and perhaps even too many options to eat, try to choose the options that provide the most color to your plate, as well as choose the options that will fuel and nourish your body, versus just fill your stomach!


Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, pilates, vinyasa yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS.  Her new book, “Healthy Things You Can Do In Front of the TV” is available on Amazon.com, and will soon be available on BN.com, and Kindle. Visit her website, bodyfriendlyoga.com

antioxidant-3445989_640

Does juicing really “detox” the body?

Anything that promises detoxification sounds a little questionable – like products that claim to “pull toxins out of your system” or “cleanse the liver.”  The body does have detoxification mechanisms that are working all the time, and both healthful eating and intermittent fasting can accelerate those processes. Several-day juice “fasts” are one way to tap into the benefits of intermittent fasting and enhance removal of toxins from the body, because the body enhances the removal of toxins when not digesting food and burning more fat for its energy needs. Our fat supply stores toxins, and when we lose body fat we release more toxic waste simultaneously. The body also needs adequate phytochemical and antioxidants for the liver to most effectively process fat-soluble toxins so they can be excreted via the urine.

Get into the catabolic phase

We’re always either in a fed state or a fasting state; you’ve likely read about the anabolic and catabolic phases of digestion in my books or articles that discuss toxic hunger. When we are eating, digesting, and absorbing nutrients from food, we are in the anabolic phase; think of it like filling your car’s tank with gas. That is followed by the catabolic phase, between meals, in which our energy needs are met by burning energy that we stored during the anabolic phase.

The catabolic phase is when most healing and self-repair happens, and there is evidence that prolonged time in this fasting (catabolic) state has significant health benefits. Also, these benefits don’t necessarily require an extended, several-day water fast, which is difficult for most people to commit to.

I always say, the longer you live in the catabolic phase, the longer you live. Here’s why: Being in a fasting state shifts the body’s cells away from growth, and instead toward a mode of maintenance and repair.1,2 This repair mode is associated with a reduction in insulin and insulin-like growth factor-1 (IGF-1) production; two hormones that play a huge role in health and longevity.3,4 These hormonal changes lead to reduced inflammation, improved insulin sensitivity and stress resistance, slower cell growth, improved immune function, and reduced oxidative stress.5,6  Fasting also stimulates autophagy, an important self-repair process. Autophagy removes damaged components from cells and tissues.7

Eating right is already detox; calorie restriction enhances the benefits

On a cellular level, many dietary phytochemicals – such as isothiocyanates derived from cruciferous vegetables, sulfur compounds from garlic and onions, and carotenoids from a variety of colorful produce – drive the production of enzymes that enable the excretion of carcinogens and other potentially harmful compounds. This detoxification system counteracts oxidative stress, inflammation, and DNA damage.8  Eating right, in itself, enables valuable detoxification mechanisms.

Caloric restriction adds to this, and has been the one intervention that extends life in a number of different species. Adding periodic calorie restriction to an already nutrient-rich diet could intensify the body’s ability to heal and repair by extending the amount of time in the fasting repair mode and reducing growth-related signals.4  It also can enhance the breakdown and excretion of fat-soluble toxins; lowering the body’s toxic load.

Intermittent fasting

Intermittent fasting or a juice detox could also be a warm-up to incorporating occasional water fasting. Back in 1995, in my book, Fasting and Eating For Health, I discussed my experience of how fasting improved health parameters in my patients. I also co-authored a series of case reports documenting remission of autoimmune diseases following supervised fasting.9  More recently, fasting has been shown to have dramatic regenerative effects on the immune system. Studies over the past few years in animals and humans have suggested that fasting signals the immune system to discard old and damaged cells and generate new cells by increasing hematopoietic stem cells. The reduction in IGF-1 signaling was a necessary factor in this immune boosting. 6,10

Intermittent fasting – usually by reducing calorie intake dramatically a few days per week – is a method for getting some of the benefits of longer-term fasting. Human studies on intermittent fasting suggest it improves insulin sensitivity and promotes weight loss.2,11,12

I recommend incorporating a juice detox into your life, with vegetable juices plus one salad per day for several days, to act as a method of intermittent fasting, to slow aging and prolong lifespan as an easier alternative to water fasting.  Water fasting has a rapidly decreasing effect at removing toxins, as nutrients necessary for the removal also decrease as the fast progresses. Also, juice fasting enables the participants to continue to work and is safer, compared to water fasting, as it prevents dehydration, loss of electrolytes and fainting. It is also compatible for people who must remain on medications, so almost anyone can participate.

Tips for juicing wisely

  • Figure out a timeline you’re comfortable with. You may want to try juicing one day a week, or you may want to try a week-long juice cleanse.
  • Juice should be mostly vegetables, not fruit. Apple juice with a little kale added doesn’t bring much benefit. The maximum amount of fruit in a vegetable juice should be one serving of a low-sugar fruit, such as green apple or berries. The rest should be nutrient-rich vegetables, leafy greens in particular. Lemon and lime juice can be added to flavor your juice without counting toward the fruit serving. Include cucumber, lettuce and celery juice, along with carrots, beets, and some leafy cruciferous greens such as cabbage, kale or bok choy.
  • Follow it up with a health-promoting diet. A few days of juicing can be a great way to reset your taste buds and jumpstart a new, healthful, nutrient-rich diet. However, there is no health benefit of trying to use a juice cleanse as temporary detox, just a break from an everyday junk food diet. This only works if you stick with a Nutritarian diet for the rest of your life, incorporating some juicing and caloric restriction episodically.
  • If you have a serious medical condition or are on any medication, consult a physician before starting a juice detox.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease. Visit him at DrFuhrman.com.

References

  1. van Niekerk G, Hattingh SM, Engelbrecht AM. Enhanced Therapeutic Efficacy in Cancer Patients by Short-term Fasting: The Autophagy Connection. Front Oncol 2016, 6:242.
  2. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev 2017, 39:46-58.
  3. Pan H, Finkel T. Key proteins and pathways that regulate lifespan. J Biol Chem 2017, 292:6452-6460.
  4. Solon-Biet SM, Mitchell SJ, de Cabo R, et al. Macronutrients and caloric intake in health and longevity. J Endocrinol 2015, 226:R17-28.
  5. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab 2014, 19:181-192.
  6. Cheng CW, Adams GB, Perin L, et al. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell 2014, 14:810-823.
  7. Mattson MP, Allison DB, Fontana L, et al. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A 2014, 111:16647-16653.
  8. Stefanson AL, Bakovic M. Dietary regulation of Keap1/Nrf2/ARE pathway: focus on plant-derived compounds and trace minerals. Nutrients 2014, 6:3777-3801.
  9. Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med 2002, 8:112, 110-111.
  10. Wu S. Fasting triggers stem cell regeneration of damaged, old immune system. In USC News2014 [http://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/]
  11. Antoni R, Johnston KL, Collins AL, Robertson MD. Effects of intermittent fasting on glucose and lipid metabolism. Proc Nutr Soc 2017, 76:361-368.
  12. Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev 2015, 73:661-67
beer in glass

Alcohol in Sport: How Bad Is It for Athletes?

Alcohol has a strong link with sport, be it with sponsorship, beer consumption after a hard workout, or teams enmeshed in a culture of heavy drinking. To address what is known—and not known—about the impact of alcohol on athletic performance, members of Professionals In Nutrition for Exercise and Sport (PINES) organized a session at the American College of Sports Medicine (ACSM) 2018 annual meeting in Minneapolis. Respected researchers answered some questions athletes commonly ask regarding alcohol and sport performance. Here’s what you might want to know.

What effect does a big night of drinking have on sports performance the next day?

Dr. Louise Burke, Head of Sports Nutrition for the Australian Institute of Sport, reported heavy drinking is common after many athletic events. For example, research with rugby players suggests they consumed an average of 13 units* of alcohol post-game, with a range of 1 to 30 units (*One unit equates to 10 grams of alcohol; 5 ounces (150-ml) wine equates to 1.5 units; a 30-ml nip of hard (40%) alcohol is 1 unit; a 375 ml (13 oz.) bottle of 4.8% alcohol beer is 1.4 units.)

What does heavy post-exercise alcohol intake do to rehydration and refueling goals?

Dr. Ron Maughan, visiting professor at St. Andrew’s University, acknowledged a modest amount of alcohol, consumed along with a balanced meal, is unlikely to have a negative impact. Alcohol impairs glycogen resynthesis only a little bit. But in the real world of sports drinking, athletes who drink a lot tend to make high fat food choices—and that can hinder optimal muscle glycogen replenishment a lot! Consuming a balanced meal before embarking on heavy drinking is probably a good idea.

Alcohol is a diuretic. One unit (10 g) of alcohol stimulates the formation of 100 ml of excess urine. The alcohol content of beer is low—and beer has a lot of water—so dehydrated athletes can effectively rehydrate with beer. Whiskey and other spirits, however, cause more water loss than they contribute.

What impact does pre-exercise alcohol have on heat tolerance/dehydration during exercise?

According to research presented by Dr. Doug Casa, professor at the University of Connecticut, pre-exercise alcohol contributes to slower running across a wide range of distances. Anecdotes, more so than much-needed research, link pre-event alcohol with poor sleep, under-hydration, reduced heat tolerance, and decreased mental function. Dr. Casa reported that one major summer road race had 20 to 25 heat injuries one year. The common denominator among those heat-stricken runners was pre-event alcohol consumption. Don’t drink excessive alcohol before an event—especially in the summer heat!

What does heavy alcohol after exercise do to weight and body-fat goals?

Dr. Barry Braun, professor at Colorado State University, said for most athletes, alcohol is a source of unwanted calories. For example, just five Heineken Light Beers add 500 calories—and that’s not counting the pepperoni pizza or nachos that you can easily overeat when alcohol lowers your inhibitions.

What effect does heavy post-exercise alcohol intake have on muscle recovery?

Dr. Stuart Phillips, professor at McMaster University, noted bad things happen during exercise and good things happens during recovery when athletes rehydrate, refuel, and repair (by consuming protein) their muscles. Adding alcohol to the recovery diet slows down muscle repair, protein synthesis, and adaptation processes. Heavy alcohol intake is not on Phillips’ list of best recovery practices for athletes to follow! Yet, he doesn’t begrudge anyone a glass or two of wine. Moderation is the key word.

What does heavy alcohol intake do to sleep?

Dr. Shona Halson, Senior Physiologist at the Australia Institute of Sport, reports that alcohol might help you fall asleep faster, but it disrupts your sleep cycles so you get less restorative sleep. Alcohol alters body temperature, which can affect how well you sleep. It also aggravates snoring (due to relaxed muscles and a lower breathing rate), so your bed partner also gets sleep deprived. Plus, you have to get up to go to the bathroom more often in the middle of the night. None of this enhances athletic performance.

What does heavy alcohol intake after exercise do to muscle soreness, injury, and inflammation? Matthew Barnes of Massey University in New Zealand noted when athletes perform exercise to which they are accustomed, alcohol’s negative effects are less pronounced compared to doing a new form of exercise. That is, after getting battered up in a game, a 200-lb rugby player who is experienced with both sport and drinking could have perhaps 20 standard drinks and still effectively perform a vertical jump! As for inflammation, players who are conditioned to both their sport and to drinking alcohol do not have a significant inflammatory response. But if you are a weekend warrior, watch out…

Why isn’t alcohol & performance better researched?

Indeed, more research would be very helpful, but few research institutions approve studies that involve alcohol + heat. The alternative is to study athletes who have already been drinking. For example, they can track the number of runners in the medical tent who consumed alcohol the night before.

Any words of wisdom?

When asked, Is beer good for runners?, running legend Jim Fixx’s answer was “Sure, if it’s the other guy drinking it.” If you stay sober, you can take advantage of other athletes’ poor judgment!


Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

ed-concept-signs

Top Ten Things a Personal Trainer Should Know About Working with Eating Disorders

Having worked as a certified personal trainer and strength and conditioning specialist early in my career, and now as a certified specialist in sport dietetics who specializes in treating clients with eating disorders who are often over-exercising, I feel it is critical for trainers to have some training about how to deal with their clients with these issues because you will be seeing these clients.  Given eating disorders can present as over-exercise and under-fueling, a personal trainer is in a position to be the first identifier of these issues and can be a key player on an eating disorders treatment team.  I often utilize personal trainers to help these clients develop exercise limits, boundaries, or assist with reiterating the “fueling and hydrating” messages the dietitian may be providing the client.  I have helped in developing a new tool available to those who work in the fitness and coaching field called Running on Empty,an online eating disorders awareness and prevention program for coaches and exercise professionals, through a non-profit eating disorders outreach and prevention organization, Eating Disorders Information Network. I have also invited one of our recovery speakers to share her tips in this article. She is both an ACE certified personal trainer and a recovery speaker for EDIN. She, Kristy Wegert, shares her thoughts as a professional who currently treats clients who are on their recovery path.

A key reference on this topic is the new International Olympic Committee’s position statement on RED-S, Relative Energy Deficiency in Sport. Many of us will work with people with sub-diagnostic cases of eating disorders who may present with many of the negative energy balance physical issues discussed in this consensus statement. Working with an exercising population means helping this population stay in energy balance or eating appropriately to fuel for the level of activity in which they are engaging without harming the body because of lack of energy for basic body systems to function.  All body systems are affected when limiting the body to too little energy to function fully, including the systems visually represented below. It is the job of the eating disorders treatment team, including the exercise professionals, to be aware of this set of possible consequences and treat/refer to treatment accordingly.

A sport dietitian’s top 5 tips for working with the exercising client with an eating disorder:

1. Keep your client in energy balance by reminding them about appropriate fueling, recovery, and hydration. Complex carbs rule before exercise. Encourage your clients to fuel on these before they train vs. training on empty. Common “on the go” examples of this can be as simple as a slice of toast or a higher carbohydrate energy bar. Encourage your client to drink hydrating fluids and even an electrolyte beverage during their training session with you. Also, most active clients need to drink 4 oz. of fluids every 15 minutes. Encourage your client to take these breaks.  Encourage your clients to have a protein recovery choice within 15-45 minutes after they finish their workout.  This could be a glass of chocolate milk or a smoothie with protein.

2. Encourage and educate your clients with a non-diet mentality. This means “All Foods Fit” and that there are “No Bad Foods.” All foods have some energy value and can fit into our performance plan. In fact, when we exercise, we have need to eat more energy. If we adapt the mentality that all foods fit, then we will have less chance of sabotaging ourselves with exercise or restriction.  Check out the references Moving Away from Diets by King, Katrina, and Hayes and Intuitive Eating by Tribole and Resch for more on this way of working with clients.

3. Be aware of different types of eating disorders or disordered eating that may present to you. An individual with Binge Eating Disorder may be a common client seeking a trainer’s help for weight loss. Be sensitive to this type of client’s energy needs, orthopedic limitations, and potential resistance to traditional exercise and Health at Any Size®.

4. If you must take any anthropometrics, make sure you discuss amongst the team who is the best person to take those measurements.Often the dietitian is the best fit on the team to do this, to discuss these results, and to comment on realistic body weight ranges and appropriate food intake to fuel activity with a sport nutrition approach in a way that is focused away from calories.

5. Set reasonable boundaries on movement to include at least 2 rest days per week; sessions not exceeding 1 hour in duration; alternate cardio and strengthening to not over-exercise; consider cross training or varying types of activities to lower risk of over-training (such as outside, non-gym activities like road biking, climbing, kayaking, etc.); encourage gentle and restorative activities during the week as well, like yoga, barre, and Pilates; support varying types of classes (dance, kickboxing, karate, etc.) that have appropriate warm-ups and cool downs and are led by a certified instructor; and lastly, exercise with others who have reasonable exercise boundaries to give one appropriate containment and normal exercise boundaries.

A personal trainer’s top 5 tips in working with an exercising client with an eating disorder:

1. Exercise will bring up past trauma in the body. It can get emotional. Be prepared for some distress and perhaps, some crying. Hence, it is important to consult with the treatment team so you are prepared and can offer the appropriate type of support.

2. Don’t assume that a small person is weak; that a larger person cannot move or has never worked out; that someone in a larger or smaller body doesn’t purge. Bottom line…never assume. Check out the Health at Any Size® movement to learn more about this mindset.

3. Offer privacy when possible. Many people in early recovery feel awkward in their own bodies. Try to help them feel as comfortable as they can during a workout. This may mean taking them out of the traditional exercise environment and away from mirrors, or going outside.

4. Get written permission to speak with therapists, doctors, dietitians, sponsors, partners, and parents. People who are in recovery from anorexia, bulimia, binge eating disorder, and OSFED need well-defined, appropriate boundaries and you may need help from the treatment team in determining this. People who are in recovery need a team to help them.

5. Fitness is about function, healthy lifestyle, and feeling good. No matter what the client asks for, focus away from aesthetics. Have fun! Exercise should be a good time for your clients. Help them have a positive experience!


This article was co-written by Page Love, Vice President of the Board for Eating Disorders Information Network (EDIN) and Kristy Wegert, recovery speaker for EDIN. Originally printed on ED Resource Catalog. Reprinted with permission.

Page Love is a registered dietitian, certified specialist in sport dietetics and nutrition therapist, and runs a thriving private practice specializing in eating disorders nutrition therapy, sports nutrition, and weight management nutrition counseling in Atlanta, Ga.  She served as a clinical dietitian for Atlanta Center for Eating Disorders for 20 years and has run ANAD groups in Atlanta for 25 years, and has served as a consultant to The Renfrew Center and Veritas Collaborative.  She has developed materials for the NEDA, Renfrew Center, and EDIN and has been published in the Renfrew Perspectives, International Journal of Sport Nutrition, and International Journal of Sport Science for Tennis Medicine.  She currently serves as the Vice-President of the board for EDIN, Eating Disorders Information Network.  She also serves as a consultant for the International Women’s Professional Tennis Tour (WTA) and the Men’s Tour, Association for Tennis Professionals (ATP), the Atlanta Ballet, The Atlanta Falcons Cheerleaders, and formerly with the Atlanta Braves.  She has recently co-authored Running on Empty, an online education program for the exercise professional working with eating disorders through Eating Disorders Information Network, a non-profit for the prevention and outreach for eating disorders in Atlanta, Ga.

At 40 years old, Kristy Wegert made some decisions that caused a mid-life career change. She decided after some much needed deep thought, that she was meant for the fitness industry. She holds an ACE Personal Trainer Certification. While she was studying for the ACE exam, she decided to get herself into the industry. There was just no point in waiting (and  she was too excited!) so she became a certified Cycle Instructor. (A little back story: Kristy lost 100 pounds after being heavy most of her life and has kept off that weight since 2008). Kristy loves to exercise and loves being an inspiration to others. Her current passion is to help others in a safe, fun way and watch them transform. Her company, My Workout Buddy, embodies everything she feels is important in the fitness industry…rigorous yet fun physical activity, a well balanced lifestyle, and the safety of a properly educated personal trainer at your side.

References

The IOC consensus statement: beyond the Female Athlete Triad

bjsm.bmj.com › Archive › Volume 48, Issue 7

Running on Empty; A online eating disorders awareness and prevention program for coaches and exercise professionals, Love and Guntermyedin.org http://www.myedin.org/athletes.html

Moving Away from Diets Hayes, Katrina, and King

Health at Any Size Bacon

Intuitive Eating Tribole and Resch

Sports, Cardiovascular, and Wellness Nutrition dietetics practice group of the Academy of Nutrition and Dietetics Practice Manual:  https://www.scandpg.org/e-learning-and-events/a-practice-manual-for-professionals/

American Council on Exercise Podcast on Why We Eat: https://www.acefitness.org/health/resources.aspx

Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

Personal trainers have the opportunity to do more than just help people they train become more active. We need to be prepared to also help our clients implement lifestyle behavior changes related to stress, family history of coronary heart disease, obesity, smoking, high blood pressure and high cholesterol.

A look at what is called metabolic syndrome will help you understand why, even though increasing physical activity levels is the overall best thing you can do for any client, there are additional ways to guide them to a healthier lifestyle. Sometimes you may be able to help them make the changes yourself; and, sometimes you will need to refer them to another health professional like a doctor or dietitian for guidance. Either way, knowing how to help them or when to direct them to someone who is more knowledgeable than you is important. So, first let’s become familiar with the syndrome and the clinical criteria that the doctor uses to diagnose it. Your goal is then to help your clients understand and make the necessary changes so that they don’t progress to cardiovascular disease and the almost certain heart attack heart that will be the end result.

Cardiovascular disease is still the number one cause of morbidity and mortality in the United States and much of this burden of disease can be linked to poor nutrition and a dramatic increase in sedentary lifestyles, leading to overweight and obesity. This increase in weight leads to an increase in the incidence of type 2 diabetes, and blood pressure and cholesterol problems, which are all well-established cardiovascular disease risk factors. The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III has updated the recommendations for the evaluation and management of adults dealing with high cholesterol, renewing its emphasis on the importance of lifestyle modifications for improving cardiovascular risk. The NCEP has coined the term “therapeutic lifestyle changes” (TLC) to reinforce both dietary intake and physical activity as crucial components of weight control and cardiovascular risk management.

As well as focusing attention on the LDL cholesterol (also called bad cholesterol) levels, the NCEP also identified metabolic syndrome as a secondary target of therapy. Metabolic syndrome (also called insulin resistance syndrome and syndrome X) is characterized by decreased tissue sensitivity to the action of insulin (pre-diabetes), resulting in a compensatory increase in insulin secretion. This metabolic disorder predisposes individuals to a cluster of abnormalities that can lead to such problems as type 2 diabetes, coronary heart disease and stroke. The prevalence of the syndrome has increased 61% in the last decade. It is crucial for medical professionals to identify patients at risk and follow these patients closely and counsel them about making lifestyle changes to lower the risk of type 2 diabetes and cardiovascular disease.

GUIDELINE: According to the NCEP, the criteria for metabolic syndrome includes at least 3 of the following 5 clinical factors

Risk factor Defining level
Abdominal obesity
Men
Women
Waist circumference
>40 in (>102 cm)
>35 in (>88 cm)
Fasting triglyceride level >150 mg/dL
HDL cholesterol level
Men
Women
 
<40 mg/dL
<50 mg/dL
BP >130/>85 mm Hg
or taking antihypertensive medication
Fasting glucose level >100 mg/dL or diabetes

Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health; 2001. NIH publication 01-3670.

Millions of Americans at risk for metabolic syndrome can sharply lower their chances of getting this disease by adopting a healthy lifestyle (stop smoking, low-fat diet, weight loss/maintenance and increased physical activity). Without diet and exercise modifications, most patients will eventually fail and progress to type 2 diabetes within a decade and experience a heart attack about 10 years later. Experts recommend a diet reduced in saturated fats (<7%), low in cholesterol (<200 mg/day), high in fiber (20-30gm/day) and reduced in simple sugars. Weight loss of only 5-7% (less than 15 pounds) can make a big difference in health markers like cholesterol and blood pressure. A program that includes daily exercise reaching 85% of heart rate for age is reported to be of benefit too. However, any exercise is better than none, and a target of 30 minutes every other day is a reasonable level for most people.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. The medical community is good at diagnosing this syndrome, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases, you have more knowledge in this area than the physician who has been trained in tertiary, not preventative, (i.e. most MD’s know very little about diet and exercise since this is not a focus in medical school) medicine.  Often times all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. A personal visit to your primary care doctor and others in your area is even better. But, be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.


Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

References

  1. Centers for Disease Control and Prevention. Early release of selected estimates based on data from the January-June 2003 National Health Interview Survey. URL: cdc.gov/nchs/about/major/nhis/released200312.htm.
  2. Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2016 https://www.cdc.gov/nchs/nhis/SHS/tables.htm 16 Apr. 2018.
  3. Centers for Disease Control and Prevention. Prevalence of health care providers asking older adults about their physical activity levels—United States, 1998. Morbidity and Mortality Weekly Report. 51(19):412-4, 2002.
  4. Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.
active adults walking

Four Sources of Stress & How to Beat Them

Stress is a normal physical response. Everyone feels stress. You may feel stress when you have too many errands to run, when you are given a promotion at work, or in your daily commute through Atlanta traffic!

During stressful times, your body responds physically by producing hormones to speed up your heart, make you breathe faster, and give you a big burst of energy. That physical reaction is called the “fight or flight” response.

Some stress is good and some stress is bad. But when stress happens too often, it can take a toll on your body. So that’s why I want to discuss where stress comes from and how you can effectively manage it.

Take a look around you. The environment in which you live can cause stress. Pollution causes stress and comes in the form of substances or energy — think trash or smog and noise or light pollution. Your environment also includes your family, home, neighbors, community, and geographic location. The people with whom you choose to surround yourself can either be uplifting and positive or upsetting and negative. Being isolated or overcrowded can also cause stress depending upon which situation you prefer.

Your diet may be causing you stress. The food that you eat either nourishes or starves your body. Do you eat mostly processed foods with chemical additives and empty calories? Doing so creates a toxic environment inside your body and allows you to become more susceptible to sickness and disease.

How much physical activity do you get? Science and medicine have proven that exercise negates the effects of bad stress on your body and in most cases it does so better than any prescription medicine. On the other hand, a lack of physical activity can make even small amounts of stress seem monumental.

Take an inventory of what you’re feeling right now. Are you worried, doubtful, fearful? Do you feel happy, confident, or at ease? Your attitude and how you choose to react to stress can either cause you more stress or help you release stress. Oftentimes people manufacture stress in their thoughts that then manifest themselves in their bodies and environment.

The good news is you have choices here. You can choose to take control of all of these factors in your life. Or you can choose to be a victim to stress and succumb to headaches, ulcers, back pain, sickness, disease, obesity, depression, unhealthy relationships…

Take a moment to look at these four areas of your life. Identify the stress points. Then allow yourself to decide whether you will take control of that stress or simply accept it.

Reprinted with permission from Christina Estrada. Originally printed on yourfamilylifestylecoach.com.


Christina Estrada is a lifestyle coach helping people discover their strengths and reset their mindset for a healthier, more fulfilling life. She is a holds multiple certifications with International Sports Sciences Association (ISSA), including Master Personal Trainer, and Specialist in Fitness Nutrition, Youth Fitness, and Senior Fitness. 

Bananas is good way for healthy carbs

Sports Nutrition: #ScienceNotOpinion

Performance starts with fueling, not training! The best way to fuel for top performance seems to be a debatable topic these days. To keep on top of the science regarding food, exercise & performance, I look to SCAN, the Sports & Cardiovascular Nutrition practice group of the Academy of Nutrition and Dietetics (AND). Here are some tidbits of  information from this year’s 35th annual meeting in Keystone CO, May 2018.

In your search for sports nutrition information, Leslie Bonci RD CSSD wants you to find #ScienceNotOpinionand #FactsOverFallacy. Here’s some of what science supports:

—Exercising in a fasted stated leads to muscle breakdown. Think twice before eating nothing before morning exercise.

—The keto diet does not enhance performance, but rather leads to a down-regulation of the enzymes needed by carbohydrates to fuel a surge or a winning sprint at an event.

—Whole30 and Intermittent Fasting are just two more fads to add to the list of unsuccessful diets. You never want to embark upon a diet you won’t maintain for the reset of your life. Otherwise, diet backlash (binge eating, weight gain) takes it toll. Learn how to eat smarter, not diet harder!

—Carb-phobia refuses to go away, despite the plethora of research supporting the performance benefits of a carb-based sports diet. #Don’tDreadTheBread.

  • Omega-3 fats (DHA, EPA) found in oily fish (salmon, tuna, mackerel) are related to brain health. Animal research (rats, mice) suggests giving intravenous DHA within an hour after brain or spinal cord injury contributes to better outcomes regarding recovery. Would the same help athletes? Could DHA help with reducing the damage done by brain injuries? According to Michael Lewis MD, athletes, war fighters and others at high risk for getting concussed should consider taking 3,000 mg. EPA + DHA per day as a protective strategy.Omega-3s can also help treat depression, and that might help reduce suicides. Among soldiers with adequate levels of omega-3, the suicide-rate was 62% lower than soldiers with low blood levels of DHA.
  • Should athletes take anti-oxidant supplements? Likely not, according to exercise physiologist Scott Powers PhD of the University of Florida in Gainesville. The body has a natural balance of pro-oxidants and anti-oxidants. An imbalance can lead to muscular fatigue and molecular damage. Anti-oxidant supplements can down-regulate the body’s natural production of anti-oxidants, and that can blunt the training response. Athletes can ingest a performance enhancing balance of anti-oxidants (including vitamins C & E, zinc, carotenoids, and polyphenols) via all sorts of colorful fruits and vegetable: blueberries, strawberries, tart cherry juice, grape juice, broccoli, spinach, carrots….
  • The Academy of Nutrition and Dietetics, along with the American College of Sports Medicine and Dietitians of Canada, have created guidelines on nutrition for athletes. But what about nutrition for fitness exercisers and weekend warriors? If that’s you, exercise physiologist Asker Jeukendrup, PhD, of www.mysportscience.com suggests you match your nutritional guidelines to your athletic goals. That is, are you exercising to lose weight? build muscle? finish an Ironman Triathlon? or just to invest in better health?

When it comes to fueling during extended exercise, Jeukendrup stated the recommendations are similar for both athletes and less fit people: For exercise that lasts from 60 to 90 minutes, you want to maintain high energy by consuming from 30 to 60 grams of carbohydrate (120 to 240 calories) per hour of exercise. If you are a weekend warrior who exercises hard for more than two hours, you want to target 60 to 90 grams carh (240 to 360 calories) per hour. You might have to start at the low end of the calorie range while you train your gut to tolerate that much fuel. (The gut is trainable!). You’ll discover that exercise is much more fun when you have high energy!

  • An estimated 35 million Americans are older than 65. By 2030, 70 million Americans will exceed the age of 85. Unfortunately, as we age, we lose muscle strength. That loss is associated with frailty and falls. Because the daily diet of an estimated 25% to 40% of older people lacks adequate protein, muscle loss gets exacerbated.

Research suggests that older people, including athletes, should increase their protein intake to 1.4 g to 1.6 g/kg per day, and up to 40 grams after hard exercise. Exercise physiologist Robert Murray, PhD,(www.sportsscienceinsights.com) reports this could help boost the muscle-building response to exercise. If you are an older athlete who weighs 150 pounds (68 kg), this means. 95 to 110 gram protein per day. That’s about 25 grams, four times a day—much more than in a bowl of oatmeal or a handful of nuts!

  • The health risks of yoyo dieting are more harmful than the (short-lived) benefits of weight loss. Julie Duffy Dillon RD (host of the Love Food podcast) reminds us that weight cycling (yoyo dieting) contributes to malnutrition, muscle loss, reduced metabolic rate, and feelings of deprivation. The binge-eating that occurs upon “blowing the diet” is linked to fat gain, inflammation, elevated blood pressure, and insulin resistance—to say nothing about disordered eating. Dieting is the #1 predictor of who will develop an eating disorder.
  • According to sports dietitian Nanna Meyer PhD RD of the University of Colorado in Colorado Springs, climate change is here. It’s time for athletes to think more about how we can be good Food Citizens and take better care of the earth that we enjoy. This could be by eating locally grown foods, choosing more plant foods, buying sustainably farmed fish, using fewer plastic water bottles, eating less food in wrappers, and buying from local farmers. Eat with integrity and with respect for the planet!

Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

Senior Field

Our Aging World

We are aging—not just as individuals or communities but as a world. In 2006, almost 500 million people worldwide were 65 and older. By 2030, that total is projected to increase to 1 billion—1 in every 8 of the earth’s inhabitants. Significantly, the most rapid increases in the 65-and-older population are occurring in developing countries, which will see a jump of 140 percent by 2030.

People are living longer and, in some parts of the world, healthier lives. This represents one of the crowning achievements of the last century but also a significant challenge. Longer lives must be paid for. Societal aging may affect economic growth and many other issues, including the sustainability of families, the ability of states and communities to provide resources for older citizens, and international relations. The Global Burden of Disease, a study conducted by the World Health Organization and the World Bank, with partial support from the U.S. National Institute on Aging, predicts a very large increase in disability caused by increases in age-related chronic disease in all regions of the world. In a few decades, the loss of health and life worldwide will be greater from noncommunicable or chronic diseases (e.g., cardiovascular disease, dementia and Alzheimer’s disease, cancer, arthritis, and diabetes) than from infectious diseases, childhood diseases, and accidents.

Since the beginning of recorded human history, young children have outnumbered older people. Very soon this will change. For the first time in history, people age 65 and over will outnumber children under age 5. This trend is emerging around the globe. Today almost 500 million people are age 65 and over, accounting for 8 percent of the world’s population.

By 2030 the world is likely to have 1 billion older people, accounting for 13 percent of the total population. While today’s proportions of older people typically are highest in more developed countries, the most rapid increases in older populations are occurring in the less developed world. Between 2006 and 2030, the number of older people in less developed countries is projected to increase by 140 percent as compared to an increase of 51 percent in more developed countries.

Population aging is driven by declines in fertility and improvements in health and longevity. In more developed countries, declines in fertility that began in the early 1900s have resulted in current fertility levels below the population replacement rate of two live births per woman. Perhaps the most surprising demographic development of the past 20 years has been the pace of fertility decline in many less developed countries. In 2006, for example, the total fertility rate was at or below the replacement rate in 44 less developed countries.

Increasing Life Expectancy

Some nations experienced more than a doubling of average life expectancy during the 20th century. Life expectancy at birth in Japan now approaches 82 years, the highest level among the world’s more developed countries, and life expectancy is at least 79 years in several other more developed countries.

Less developed regions of the world have experienced a steady increase in life expectancy since World War II, with some exceptions in Latin America and more recently in Africa, the latter due to the impact of the HIV/AIDS epidemic. The most dramatic gains have occurred in East Asia, where life expectancy at birth increased from less than 45 years in 1950 to more than 72 years today.

Changes in life expectancy reflect a health transition occurring around the globe at different rates and along different paths. This transition is characterized by a broad set of changes that includes:

  • A shift from high to low fertility;
  • A steady increase in life expectancy at birth and at older ages; and
  • A shift from the predominance of infectious and parasitic diseases to the growing impact of noncommunicable diseases and chronic conditions.

The health transition shifts the human survival curve so that the chances of surviving another year are higher at every age. In early nonindustrial societies, the risk of death was high at every age, and only a small proportion of people reached old age. In modern survival curves for industrialized societies, most people live past middle age, and deaths are highly concentrated at older ages.

Increases in the probability of survival raise questions about limits to life expectancy and the potential for human lifespan. Despite assertions that life expectancy must be approaching a limit, data on female life expectancies from 1840 to 2000 show a steady increase of 3 months per year. The country with the highest average life expectancy has varied over time—in 1840 it was Sweden, and today it is Japan.

Recent research raises other questions about the future of life. Researchers have been able to experimentally increase lifespan in insects and animals through gene insertion, caloric restriction, and diet. It remains to be seen whether similar increases can be replicated in humans.

Rising Numbers of the Oldest Old

An important feature of population aging is the progressive aging of the older population itself. Over time, more older people survive to even more advanced ages. For research and policy purposes, it is useful to distinguish between the old and the oldest old, often defined as people age 85 and over. Because of chronic disease, the oldest old have the highest population levels of disability that require long-term care. They consume public resources disproportionately as well.

The growth of the oldest old has a number of implications:

  • Pensions and retirement income will need to cover a longer period of life.
  • Health care costs will rise even if disability rates decline somewhat.
  • Intergenerational relationships will take on an added dimension as the number of grandparents and great-grandparents increase.
  • The number of centenarians will grow significantly for the first time in history. This will likely yield clues about individual and societal aging that redefine the concept of oldest old.

The oldest old constitute 7 percent of the world’s 65-and-over population: 10 percent in more developed countries and 5 percent in less developed countries. More than half of the world’s oldest old live in six countries: China, the United States, India, Japan, Germany, and Russia. In many countries, the oldest old are now the fastest growing portion of the total population. On a global level, the 85-and-over population is projected to increase 151 percent between 2005 and 2030, compared to a 104-percent increase for the population age 65 and over and a 21-percent increase for the population under age 65. Past population projections often underestimated decreases in mortality rates among the oldest old; therefore, the number of tomorrow’s oldest old may be significantly higher than anticipated.

The percentage of oldest old will vary considerably from country to country. In the United States, for example, the oldest old accounted for 14 percent of all older people in 2005. By 2030, this percentage is unlikely to change because the aging baby boom generation will continue to enter the ranks of the 65-and-over population. In Europe, some countries will experience a sustained rise in their share of oldest old while others will see an increase during the next two decades and then a subsequent decline. The most striking increase will occur in Japan: By 2030, nearly 24 percent of all older Japanese are expected to be at least 85 years old. Most less developed countries should experience modest long-term increases in their 85-and-over population.

As life expectancy increases and the oldest old increase in number, four-generation families become more common. The aging of the baby boom generation, for example, is likely to produce a great-grandparent boom. As a result, some working adults will feel the financial and emotional pressures of supporting both their children and older parents and possibly grandparents simultaneously.

While people of extreme old age—that is, centenarians—constitute a small portion of the total population in most countries, their numbers are growing. The estimated number of people age 100 and over has doubled each decade since 1950 in more developed countries. In addition, the global number of centenarians is projected to more than quintuple between 2005 and 2030. Some researchers estimate that, over the course of human history, the odds of living from birth to age 100 may have risen from 1 in 20 million to 1 in 50 for females in low-mortality nations such as Japan and Sweden.

PROJECTED INCREASE IN GLOBAL POPULATION BETWEEN 2005 AND 2030, BY AGE
Age Increase
0-64 21%
65+ 104%
85+ 151%
100+ 400+%

Source: United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects.

Growing Burden of Noncommunicable Diseases

In the near future, the loss of health and life in every region of the world, including Africa, will be greater from noncommunicable or chronic diseases, such as heart disease, cancer, and diabetes, than from infectious and parasitic diseases. This represents a shift in disease epidemiology that has become the focus of increasing attention in light of global aging.

There is extensive debate about the relationship between increased life expectancy and disability status. The central question is: Are we living healthier as well as longer lives, or are our additional years spent in poor health? Some researchers posit a “compression of morbidity”—a decrease in the prevalence of disability as life expectancy increases. Others contend an “expansion of morbidity”—an increase in the prevalence of disability as life expectancy increases. Yet others argue that, as advances in medicine slow the progression from chronic disease to disability, there is a decrease in the prevalence of severe disability but an increase in milder chronic diseases.

A Host of Challenges

While global aging represents a triumph of medical, social, and economic advances over disease, it also presents tremendous challenges. Population aging strains social insurance and pension systems and challenges existing models of social support. It affects economic growth, trade, migration, disease patterns and prevalence, and fundamental assumptions about growing older.

Using data from the United Nations, U.S. Census Bureau, and Statistical Office of the European Communities as well as regional surveys and scientific journals, the U.S. National Institute on Aging (NIA), with input from demographers, economists, and experts on aging, identified nine emerging trends in global aging. Together, these trends present a snapshot of challenges and opportunities that clearly show why population aging matters.

  • The overall population is aging. For the first time in history, and probably for the rest of human history, people age 65 and over will outnumber children under age 5.
  • Life expectancy is increasing. Most countries, including developing countries, show a steady increase in longevity over time, which raises the question of how much further life expectancy will increase.
  • The number of oldest old is rising. People age 85 and over are now the fastest growing portion of many national populations.
  • Noncommunicable diseases are becoming a growing burden. Chronic noncommunicable diseases are now the major cause of death among older people in both more developed and less developed countries.
  • Some populations will shrink in the next few decades. While world population is aging at an unprecedented rate, the total population in some countries is simultaneously declining.
  • Family structures are changing. As people live longer and have fewer children, family structures are transformed, leaving older people with fewer options for care.
  • Patterns of work and retirement are shifting. Shrinking ratios of workers to pensioners and people spending a larger portion of their lives in retirement increasingly strain existing health and pension systems.
  • Social insurance systems are evolving. As social insurance expenditures escalate, an increasing number of countries are evaluating the sustainability of these systems.
  • New economic challenges are emerging. Population aging will have dramatic effects on social entitlement programs, labor supply, trade, and savings around the globe and may demand new fiscal approaches to accommodate a changing world.

A Window of Opportunity

Global aging is a success story. People today are living longer and generally healthier lives. This represents the triumph of public health, medical advancement, and economic development over disease and injury, which have constrained human life expectancy for thousands of years. But sustained growth of the world’s older population also presents challenges. Population aging now affects economic growth, formal and informal social support systems, and the ability of states and communities to provide resources for older citizens. We can think about preparing for older age on both an individual and societal level. On an individual level, people need to focus on preventive health and financial preparedness.

Since the mid-19th century, the life span in the US has nearly doubled. Most of the increase in life expectancy is due to declines in death from infectious disease. Unfortunately, the number of deaths from infectious disease has been replaced by the number of deaths from degenerative or “lifestyle” diseases. Most people would agree that living a long life without health and independence is not desirable. So, when we consider that an increasing number of people are living longer, we must also consider the problems that are created when the quality of these extended years is poor.

Morbidity is defined as the absence of health. All too often it is a state in which many frail elderly live for a long time prior to death. The major chronic diseases that contribute greatly to morbidity are arteriosclerosis, cancer, osteoarthritis, diabetes, and emphysema. These diseases usually begin early in life, progress throughout the lifespan, and worsen each decade until finally becoming terminal. An example is diabetes. It could begin with obesity at age 20, progress to glucose intolerance at age 30, develop into elevated blood glucose at age 40, be indicated by sugar in the urine at age 50, require medication at age 60, and lead to blindness and amputation at age 70. This is not a pretty picture.

The social consequences of an unhealthy older population are huge. Sickly elderly individuals become more and more unproductive which makes them and the family members caring for them miserable. All of this imposes a huge financial burden on society overall.

It has been estimated that by the year 2040 the average life expectancy of older people could increase by 20 years. By the middle of the 21st century there could be 16 million people in the US over the age of 85. It is also estimated that the average 65-year-old will spend 7½ years of this remaining 17 years living with some functional disability. If the present rate at which people are being added to the category of those experiencing morbidity is projected to the future, a 600% increase in healthcare costs will occur. Still expecting Medicare to take care of us all? Social and medical programs are directly linked to the size and health status of the elderly population in a society. The quality of life of our elderly – and in fact for all of us – will be affected not only by the number of years our seniors live, but also by how comfortably they spend those remaining years.

The emphasis in gerontological research has begun to shift from lengthening life to increasing years of health. The new goal is to shorten the period of time that people live in an unhealthy, dependent state. If scientific advances allow us to live 15 or 20 years longer, and if these 15-20 years consist mainly of pain, suffering, and dependence on others, what have we accomplished?

Because chronic diseases begin early in life and develop gradually, a healthy lifestyle can greatly postpone or even prevent the start of some of these chronic diseases like diabetes, emphysema, and heart disease. The longer the diseases are prevented, the less time an individual will experience morbidity in later years. As a matter of fact, individuals who practice sound health habits and prevent the onset of chronic disease for many years might NEVER experience morbidity.

While it is important for health professionals to develop and enhance life-extending strategies, we also must provide strategies that enable people to live as well as they can. There needs to be a balance between quantity and quality.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. If you are interested in working with older adults, it is important to have the knowledge base to safely and effectively train them. A good overall program to consider is the SrFit Mature Fitness Program, which is recognized for continuing education by many certification organizations including ACSM, BOC, NASM, NSCA, YMCA and others. You can check it out by going to www.aahf.info.

The medical community is good at diagnosing chronic lifestyle diseases, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases you will have more knowledge in this area than the physician who has been trained in tertiary, not preventative, medicine. Most MD’s know very little about diet and exercise since they are not taught this in medical school. Often all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. Be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.

Originally published on American Academy of Health and Fitness. Reprinted with permission from Tammy Petersen.


Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

Source

Much of the information provided here was taken from a report prepared by the U.S. State Department in collaboration with the National Institute on Aging.

NIH Pub ID: 07-6134

CIMS Pub ID: BK025

The National Institute on Aging (NIA), part of the National Institutes of Health, was established to improve the health and well-being of older people through research. As part of its mission, the NIA investigates ways to support healthy aging and prevent or delay the onset of diseases disproportionately affecting older adults. NIA’s research program covers a broad range of areas, from the study of basic cellular changes with age to the examination of the biomedical, social, and behavioral aspects of age-related conditions. Although the main purpose of this research is to increase “active life expectancy” — the number of years free of disability — it may also promote longevity.

supplements

Sports Supplements: Buyer Beware?

Definition of Sports supplement: A food, food component, nutrient, or non-food compound that is purposefully ingested in addition to the habitually consumed diet with the aim of achieving a specific health and/or performance benefit.

The global sports nutrition supplement market (including sports foods, drinks and supplements) accounted for $28+ billion in 2016 and, with the help of rigorous advertising, is expected to almost double by 2022. How many of the products are moneymaking ploys marketed to uninformed athletes? Unfortunately, too many.

Due to the plethora of products that have infiltrated gyms, fitness centers and professional sports teams alike, I get questioned by fitness exercisers and aspiring Olympians: Which of these supplements are actually effective?? Hands down, the most effective way to enhance sports performance is via your day-to-day sports diet, coordinated with a consistent training program. Eating the right foods at the right times creates the essential foundation to your success as an athlete.

That said, specific sports supplements could make a minor contribution to small performance improvements for certain elite athletes. If you wonder if the grass is greener on the other side of your sports diet’s fence, here are some facts from the 2018 IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete (1).

  • Supplement use varies across sports. It increases with the athletes’ training level and age, is higher in men than women and is strongly influenced by perceived cultural norms. (For example, “Everyone” on my team takes creatine, so I do, too.)
  • Before making any decisions regarding sports supplements, you want to get a nutritional assessment to be sure your diet supports your performance goals. No amount of supplements will compensate for a lousy diet. To find a local sports dietitian who is a Certified Specialist in Sports Dietetics (CSSD), use the referral network at www.SCANdpg.org.
  • Despite the ads you see for a zillion sports supplements, very few have strong proof of directly enhancing performance. These include caffeine, creatine, specific buffering agents, and nitrate. Period.
  • Very little research with supplements offers definitive evidence, in part because the research is rarely done with elite athletes under real life conditions. Real life includes 1) multi-day tournaments, competitions or events, 2) “stacking” supplements (such as mixing caffeine and nitrates) and 3) determining if an elite athlete responds the same way to a supplement as does a Division-3 collegiate athlete. Real life also includes your unique microbiome (the bacteria in your gut that influence your overall health and well-being). We do not yet know how much a microbiome, which varies 80% to 90% between individuals, influences the effectiveness of a sports supplement and contributes to different responses.

Supplements are used for many different reasons. Here’s a breakdown of supplements by categories.

  1. Supplements used to prevent/treat nutrient deficiency. Nutrients of concern for athletes include iron (to prevent anemia), calcium and vitamin D (for bone health), as well as iodine, folate and B-12 for specific sub-groups of athletes, including vegans and women who might become pregnant. The basic supplement question is: If you are deficient, what led to that deficiency and what dietary changes will you make to resolve the issue so that it doesn’t happen again?
  2. Supplements used to provide energy. Sports drinks, energy drinks, gels, electrolyte replacements, protein supplements, energy bars, and liquid meals are commonly used to help meet energy needs before, during and after exercise. They are a convenient, albeit more expensive alternative to common foods. They aren’t magical or superior to natural food. They are just easy to carry, standardized and eliminate decisions about which foods would offer, let’s say, the “recommended ratio” of carbs, protein and fat.
  3. Supplements that directly improve performance. Caffeine, creatine monohydrate, nitrate, sodium bicarbonate, and possibly beta-alanine are the very few performance enhancing supplements that have adequate support to suggest they may offer a marginal performance gain. If you choose to use them, be sure to test them thoroughly during hard training that mimics the competitive event. Choose a brand that is NSF Certified for Sport to minimize the risk of inadvertent doping due to contamination. Every year, athletes get suspended for failing a drug test after they unknowingly took a supplement with an illegal ingredient…
  4. Supplements that indirectly improve performance. Some supplements claim to enhance performance indirectly by supporting the athlete’s health and limiting illness. “Immune support” supplements that have moderate research to support their health claims include probiotics, vitamin D, and vitamin C. Supplements that lack strong support for their immune-enhancing claims include zinc, glutamine, Echinacea, vitamin E, and fish oil. Tart cherry juice and curcumin show promise

A supplement with strong evidence to indirectly improve performance by helping build muscle is creatine monohydrate. Questionable supplements without strong evidence for athletes include gelatin and HMB.

Adverse Effects

If some supplements are good, would more be better? No, supplements can cause harm. Too much iron can lead to iron overload. Too much caffeine increases anxiety. Supplements are linked to liver toxicity, heart problems and seizures. In the USA in 2015, dietary supplements contributed to about 23,000 emergency department visits. Manufacturers are not required to show safety or assure quality of a supplement. Athletes beware— and try eating better to perform better?


Nancy Clark, MS, RD, CSSD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathon-ers, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

References

Maughan R, Burke L, Dvorak J et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete Intl J Sports Nutr Exerc Metab 2018, 28: 104-125.

https://globenewswire.com/news-release/2017/01/10/904591/0/en/Global-Sports-Nutrition-Market-will-reach-45-27-Billion-by-2022-Zion-Market-Research.html